A blog covering the health/care ecosystem and people.

Americans’ perception of the quality of health care in the U.S. fell to the lowest level since 2001, Gallup found in a poll of U.S. health citizens’ views on health care quality, published December 6, 2024.              In 2024, only 44% of Americans said that the quality of health care int he U.S. was excellent or good — conversely, 56% of Americans though health care quality was only fair or poor. By political party, that included 50% of Democrats evaluating the quality of care highly compared with 42% of Republicans. Only 28% of people in

Patients “yearn” for personalized services and relationships in health care — optimistic that technology can help deliver on that hope — we learn in Healthcare’s Future: Balancing Progress and Perception, a health consumer survey report from Lavidge. Lavidge, a communications/PR/marketing consultancy, polled U.S. patients’ attitudes about health care and technology in June 2024, publishing the report earlier this month.                   Start with over-arching finding that, “Three out of four patients believe the U.S. healthcare system is broken and there is a strong sense of distrust,” Lavidge asserts right at the top of

Today marks eight days before #Election2024 in the U.S. While many political pundits assert that “health care is not on the ballot,” I contend it is on voters’ minds in many ways — related to the economy (the top issue in America), social equity, and even immigration (in terms of the health care workforce). In today’s Health Populi blog, I’m digging into  Access Denied: patients speak out on insurance barriers and the need for policy change, a study conducted by Ipsos on behalf of PhRMA, the Pharmaceutical Research and Manufacturers of America — the pharma industry’s advocacy organization (i.e., lobby

The marketing for purchasing digital health technologies is expecting to grow, driven by increased consumer demands for tech-based solutions, improved outcomes enabled through the innovations, and cost savings derived from deploying the technologies. That’s the top-line finding in the 2024 State of Digital Health Purchasing from the Peterson Health Technology Institute (PHTI).           PHTI surveyed 322 digital health decision makers working in employers, health plans, and health systems, fielding the study in July and August 2024.           3 in 4 purchasers grew spending on digital health technologies in the past two years,

“If the U.S. were sensible, weight management would be treated as a public health issue,” David Cutler writes in the JAMA Health Forum dated August 15, 2024. Dr. Cutler, distinguished economics professor at Harvard, talks about “the pathology of U.S. health care” citing the example of weight loss medications — in short, the uptake of GLP-1 drugs to address Type 2 diabetes first, and subsequently obesity.          Dr. Cutler notes that the price of these drugs in the U.S. “far exceeds” that of other countries: specifically, 9 times that of the prices in Germany and the Netherlands

Millions of Americans believe they have been treated negatively by a physician due to their weight, insurance status, physical appearance and/or state of mental health, according to a YouGov poll published August 6, 2024.                  To gauge U.S. health citizens’ perceptions of fair and unfair treatment in the health care system, YouGov conducted this research among 1,200 U.S. adults 18 and over online in late June 2024. The first bar chart arrays various identity characteristics describing patients: we see that weight is by far the top characteristic putting the person at-risk for being

The average person in the U.S. retiring in 2024 will need to bank $165,000 to pay for health care costs in retirement — a sum that does not include long-term care, Fidelity Investments advises us in the 23rd annual look at this always-impactful (and sobering) forecast. I’ve covered this study every year since 2011 here in Health Populi, continuing to add to this bar chart; in the interest of space and legibility, I started this year’s version of the chart at 2014, when the cost for a couple was gauged at $220K.             Fidelity began

With 70 different clinical trials for GLP-1 drugs in process with the FDA, payers — and other stakeholders in the health care ecosystem — have the semaglutide-SENSE top of mind, based on my ongoing updating of this fast-moving market space.               For overall market context on pace-of-growth in adoption, check out this chart from a JAMA Health Forum research letter on Prescription Fills for Semaglutide Products by Payment Method, published August 2nd. The study was based on the IQVIA National Prescription Audit PayerTrak data which captures 92% of Rx’s filled at retail pharmacies in

On June 11, Rohit Chopra, the Director of the Consumer Financial Protection Bureau (CFPB) announced the agency’s vision to ban Americans’ medical debt from credit reports. He called out that, “In recent years, however, medical bills became the most common collection item on credit reports. Research from the Consumer Financial Protection Bureau in 2022 showed that medical collections tradelines appeared on 43 million credit reports, and that 58 percent of bills that were in collections and on people’s credit records were medical bills.” Chopra further explained that medical debt on a consumer credit report was quite different than other kinds

Health care costs for an “average” person covered by an employer-sponsored PPO in the U.S. rose 6.7% between 2023 and 2024, according to the 2024 Milliman Medical Index. Milliman also calculated that the largest driver of cost increase in health care, accounting for nearly one-half of medical cost increases, was pharmacy, the cost of prescription drugs, which grew 13% in the year.             The big number this year is $32,066, which is the cost of that employer-sponsored PPO for a family of 4 in 2024. I’ve curated the chart of the MMI statistic for many

In the past year, the growth of prescription drug utilization and spending has much to do with the use of GLP-1 agonists to treat diabetes and obesity, along with immunology therapy, and lipid meds, along with specialty medicines now accounting for over half of spending — up from 49% in 2018. This update comes from The Use of Medicines in the U.S. 2024 from the IQVIA Institute for Human Data Science. The annual report details trends in health services utilization, the use of prescription drugs, patient financing of those costs, the drivers underpinning the medicines spending, and an outlook to 2028.

This post follows up Part 1 of a two-part series I’ve prepared in advance of the AHIP 2024 conference where I’ll be brainstorming these scenarios with a panel of folks who know their stuff in technology, health care and hospital systems, retail health, and pharmacy, among other key issues. Now, let’s dive into the four alternative futures built off of our two driving forces we discussed in Part 1.             The stories: 4 future health care worlds for 2030 My goal for this post and for the AHIP panel is to brainstorm what the person’s

Since the introduction of GLP-1 drugs on the market, their use has split into two categories: for obesity and “recreationally,” according to the Chief Economist with UBS (formerly known as Union Bank of Switzerland). Paul Donovan, said economist, discusses The economics of getting thin in his regularly published comment blog.                   “These different uses have different economic consequences,” Donovan explains: Obese patients who use GLP-1s should become more productive employees, Donovan expects — less subject to prejudice, and less likely to be absent from work. While so-called recreational GLP-1 consumers may experience these

Three major milestones marked March 2024 which compel us to note the growing role of patients-as-consumers — especially for self-prescribing medicines and medical devices. This wave of self-prescribed healthcare is characterized by three innovations: the Opill, GLP-1 receptor agonists, and Dexcom’s Continuous Glucose Monitoring (CGM) system that’s now available without a prescription. Together, these products reflect a shift in health care empowerment toward patients as consumers with greater autonomy over their health care when the products and services are accessible, affordable, and designed with the end-user central to the value proposition and care flows. Let’s take a look at each

Three in four people in the U.S. have used virtual care, now, “Table-stakes…here to stay for patients and providers. However, that ubiquity comes with its own set of market pressures…shifting from pandemic-responsiveness to market- and consumer- responsiveness,” according to The new era of consumer engagement, Rock Health’s ninth annual Consumer Adoption Survey published 18 March.            Convenience and waiting time are the top two reasons for choosing virtual over in-person care, Rock Health found. While virtual care is ubiquitous across the U.S. health care delivery landscape, patients-as-health care consumers are becoming more savvy and discriminating based

In the U.S., national news media, Federal statistics, dozens of business leaders  and the Federal Reserve Bank have been talking about an historically positive American economy on a macro level. But among individual residents of the U.S., there is still a negative feeling about the economy in a personal context, revealed in the Kaiser Family Foundation Health Tracking Poll for February 2024.                I’ve selected three figures of data from the KFF’s Poll which make the point that in peoples’ negative feelings about the national economy, their personal feelings about medical costs rank high

As a constant observer and advisor across the health/care ecosystem, for me the concept of a “health plan” in the U.S. is getting fuzzier by the day. Furthermore, health plan members now see themselves as medical bill payers, seeking value and consumer-level services for their health insurance premium investment. Weaving these ideas together is my mission in preparing a session to deliver at the upcoming AHIP 2024 conference in June, I’m thinking a lot about the evolving nature of health insurance, plans, and the organizations that provide them. To help me define first principles, I turned to the American father

Most people over 70 years of age recognize technology’s role in supporting peoples’ health, we learn from a new report on 2024 Tech Trends and Adults 50+ from AARP. But adoption and ongoing use of digital innovations among older people will be tempered without attending to four key barriers that carry equal weight in the minds of 50+ consumers: design and user experience, awareness and interest, cost and acquisition, and trust and privacy concerns. [Spoiler alert: in the Hot Points, below, I add a fifth consideration: health equity + dignity].             To gauge older Americans’ views on

Nurses rank highest among various factors in the U.S. health system in the latest Gallup poll — earning a grade of “excellent” or “good” by American adults surveyed in November 2023.               Further substantiation for nurses’ topping this poll of excellent care is that Gallup found historic low confidence in the U.S. health system among Americans  earlier this year in a July study. Note that 8 in 10 consumers rate nurses excellent/good compared with  7 in 10 people ranking physicians this way, 6 in 10 for hospitals, 5 in 10 for telemedicine/virtual visits, and

Two-thirds of U.S. consumers say they can’t afford to pay their medical bills on-time, based on the 2023 Consumer Survey from Access One, a financial services company focused on healthcare payments.               The report’s title page asks the question, “What options do consumers really want for paying healthcare expenses?” The survey report responds to that question, finding out that nearly one-half of patients have taken some kind of action to reduce their medical expenses. Furthermore, one-third of consumers are not confident they could pay a medical bill of $500 or more. Access One fielded

“Simplicity is the ultimate sophistication,” Leonardo DaVinci wrote through his lens on innovation. Simplicity can be a transformational cornerstone of health/care innovation, we learn from Siegel+Gale’s report on the World’s Simplest Brands Tenth Edition (WSBX). Siegel+Gale found the most consumers are willing to pay more for simpler brand experiences and are more likely to recommend a brand for those simpler experiences, as well.             Across the 15,000 consumers the firm polled globally (across nine countries), five key factors underpin peoples’ experiences with the enchantingly “simple” companies: they are, Easy to understand Transparent and honest Caring for

As patients assume more financial skin in their personal healthcare, they take on the role of demanding consumer, or “impatient patients.” HealthEdge’s latest research into health consumers’ perspectives finds peoples’ satisfaction with their health insurance plans lacking, with members seeking easier access their personal health information, high levels of service, and rewards for healthy behaviors.           Health plans would also boost consumers’ satisfaction by channeling patients’ access to the kinds of medical providers that align with consumers’ preferences and personal values, and by personalizing information to steer people toward lower-cost care.          

With consumer and prescriber interest in GLP-1 receptor agonist drugs “soaring,” health plan managers have a new source of financial stress and clinical questions on their to-do list. A team of Virta Health leaders held a webinar on 13th July 2023 to explain the results of a study the company just completed assessing health plan execs’ current views on Ozempic and other GLP-1 medicines with a view on both clinical outcomes and cost implications for this growing category of drugs that address diabetes and obesity.             Indeed, diabetes and obesity are top health concerns among the

The UK’s National Health Service (NHS) turns 75 today.             The NHS was the brainchild of Minister of Health Aneurin Bevan; he wrote in a statement to doctors and nurses in The Lancet on July 3, 1948,  “My job is to give you all the facilities, resources, apparatus and help I can, and then to leave you alone as professional men and women to use your skill and judgement without hindrance.” This week in The Lancet, the editors assert, “The founding principles of the NHS put into practice 75 years ago are at risk of

People love being health-insured, but their negative experiences with health plans create serious burdens on patients-as-consumers. And those burdens impact even more people who are unwell than healthier folks. The 2023 Kaiser Family Foundation Survey of Consumer Experiences with Health Insurance updates our understanding of and empathy for insured peoples’ Patient Administrative Burdens (PAB). For this study, KFF polled 3,605 U.S. adults 18 and over in February and March 2023 who had health insurance across different plan types. Over the past several years, I’ve come to appreciate the concept of PAB by listening to and learning from colleagues Dr, Grace

In health care, one of the “gifts” inspired by the coronavirus pandemic was the industry’s fast-pivot and adoption of digital health tools — especially telehealth and more generally the so-called “digital front doors” enabling patients to access medical services and personal work-flows for their care. Two years later, Experian provides a look into The State of Patient Access: 2023.                     You may know the name Experian as one of the largest credit rating agencies for consumer finance in the U.S. You may not know that the company has a significant footprint

“Healthcare costs came roaring back in 2021” after falling in 2020. In 2023, that roaring growth in health care costs continues with expected growth of 5.6%.             For 2023, you could take your $31K+ and buy a Toyota Corolla Cross Hybrid auto, fund a year at the Gnomon School in Hollywood toward a degree in animation or game design, or buy healthcare for your family of 4. Welcome to this year’s annual look at health care costs for a “typical” U.S. family explained in the 2023 Milliman Medical Index (MMI).            

Reviewing the annual 2023 report from the IQVIA Institute for Human Data Science discussing The Use of Medicines in the U.S. is always a detailed, deep, and insightful dive into the state of prescription drugs. It’s a volume speaking volumes on the current picture of prescribed meds, spending and revenues, health care utilization trends, and a forecast looking out to 2027. In my read of this year’s review, I see a flashing light for U.S. health care: “Wake up, public health!” I’ve pulled out a few of the data points that speak to me about population health, prevention and early

The U.S. is an outlier in the world for high health care spending, as well as in low achievement for life expectancy at birth — 3 years less than that in peer OECD countries — discussed in U.S. Health Care from a Global Perspective, 2022: Accelerating Spending, Worsening Outcomes, the latest look into American health system performance in a global context from The Commonwealth Fund. Another study published in JAMA this week talks about the Organization and Performance of US Health Systems, calling out the fact that, “Small quality differentials combined with large price differentials suggests that health systems have

The cost of health insurance for a worker who buys into a health plan at work in 2022 reached $22,463 for their family. The average monthly mortgage payment was $1,759 in mid-2022.               “When housing and health both rank as basic needs in Maslow’s hierarchy, what’s a health system to do?” I ask in an essay published today on Crossover Health’s website titled Value-Based Care: Driving a Social Contract of Trust and Health. The answer: embrace value-based care. Warren Buffett wrote Berkshire Hathaway shareholders in 2008, asserting that, “Price is what you pay. Value

While consumers’ satisfaction with inpatient care experiences improved a few points over the past year, health insurance and hospitals still fall in the bottom-third of all industries with which people interact, according to the American Customer Satisfaction Index (ACSI) Insurance and Health Care Study 2021-2022.               “With visitor restrictions relaxing and more elective procedures going forward, hospitals are slowly coming out of a COVID-induced satisfaction slump,” the study press released quoted Forrest Morgeson, Assistant Professor of Marketing at Michigan State University. This year’s ACSI Insurance and Health Care Index was developed through 12,840 consumer interviews

What happens to a health care ecosystem when the volume of patients and revenues they generate decline? Add to that scenario a growing consensus for a likely recession in 2023. How would that further impact the micro-economy of health care?                   A report from Trilliant on the 2022 Trends Shaping the Health Economy helps to inform our response to that question. Start with Sanjula Jain’s bottom-line: that every health care stakeholder will be impacted by reduced yield. That’s the fewer patients, less revenue prediction, based on Trilliant’s 13 trends re-shaping the U.S. health

Virtually every closed-door meeting I have had in the U.S. with a client group in the past several months has had a line item on the agenda to brainstorm the impact and opportunity of care-at-home, hospital-to-home, or Care Everywhere. This has happened across many stakeholders in the evolving health/care ecosystem of suppliers, including hospital systems, health plans, grocery chains, retail pharmacy, consumer technology, digital health and tech-enabled providers, pharma and medical supply companies. On October 10, Dr. Robert Pearl, former CEO of The Permanente Medical Group, published a provocative post on Forbes noting that Amazon, CVS, Walmart Are Playing Healthcare’s

“The odds are against hospitals collecting patient balances greater than $7,500,” the report analyzing Hospital collection rates for self-pay patient accounts from Crowe concludes.       Crowe benchmarked data from 1,600 hospitals and over 100,00 physicians in the U.S. to reveal trends on health care providers’ ability to collect patient service revenue. And bad debt — write-offs that come out of uncollected patient bill balances after “significant collection efforts” by hospitals and doctors — is challenging their already-thin or negative financial margins.           The first chart quantifies that bad debt attributable to patients’ self-pay payments

“Partnerships, including JVs and alliances with other healthcare organizations and with new entrants, are just one way to access new capabilities, unlock speed to market, and achieve capital, scale, and operational efficiencies” in health care transformations. “In an environment with continued competition for attractive assets and significant capital in play from institutional investors, these partnerships may also be the most accessible way for organizations to capture value in expanding healthcare services and technology value pools,” we learn in Overcoming the cost of healthcare transformation through partnerships from a team of health care folks with McKinsey & Company.      

Today we review the various viewpoints on Amazon’s announced acquisition of One Medical (ONEM, aka 1life Healthcare) which has been a huge story in both health care trade publications, business news, and mainstream media outlets. Welcome to Day 2 of The Retail Health Battle Royale in the U.S., my week-long update of the American retail health/care ecosystem weaving the latest updates from the market and implications and import for health care consumers.       The deal was announced on 21 July, with Amazon striking the price at about $3.9 billion. Goldman Sachs and Morgan Stanley put the deal together,

Declines in preventive care services like cancer screenings and blood glucose testing concern employers, whose continued to cover health insurance for employees during the pandemic.                       “As we enter the third year of the COVID-19 pandemic, employers continue to battle escalating clinical issues, including delayed care for chronic conditions, postponed preventive screenings, and the exponential increase in demand for behavioral health services,” the Chief Medical Officer for Castlight Health notes in an analysis of medical claims titled Millions of People Deferred Crucial Care During the Pandemic, published in June. The

When high-deductible health plans became part of health insurance design in America, they were lauded as giving patients “more skin in the game” of health care payments. The theory behind consumer-directed care was that patients-as-consumers would shop around for care, morph into rational consumers of medical services just as they would do purchasing autos or washing machines, and shift the cost-curve of American health care ever downward. That skin-in-the-game has been a risk factor for .some patients to postpone care as well as take on medical debt — the strongest predictor of which is dealing with multiple chronic conditions. “The

“I am a health care executive who happens to be a patient, caregiver, and advocate,” Stacy Hurt explained to me in a Zoom chat we shared on 31 May. I asked her to meet with me to discuss her professional news update: being appointed Parexel’s first Patient Ambassador.                       My Zoom invitation to Stacy was a very convenient excuse for me to catch up with a friend in the field: we have known each other since Stacy started to grow her health-social media presence on Twitter. And that involvement in

For millions of older people in America, health and well-being got worse in the wake of the COVID-19 pandemic. Physical, mental and behavioral health took hits, depending on one’s living situation, social determinants of health risks, and even health plan, I write in the Medecision Liberate Health blog.                     In this essay on health disparities and equity for older adults, I weave together new data from, The United Health Foundation’s study on seniors’ health status in America’s Health Rankings for 2022 RAND and CMS research into seniors health disparities among Medicare Advantage

Year 3 into the COVID-19 pandemic, health citizens are dealing with coronavirus variants in convergence with other challenges in daily life: price inflation, civil and social stress, anxiety and depression, global security concerns, and the safety of their families. Add on top of these significant stressors the need to deal with medical bills, which is another source of stress for millions of patients in America. I appreciated the opportunity to share my perspectives on “The Patient As the Payer: How the Pandemic, Inflation, and Anxiety are Reshaping Consumers” in a webinar hosted by CarePayment on 25 May 2022. In this

The financial toxicity of health care costs in the U.S. takes center stage in Health Populi this week as several events converge to highlight medical debt as a unique feature in American health care. “Medical debt is the most common collection tradeline reported on consumer credit records,” the Consumer Financial Protection Bureau called out in a report published March 1, 2022. CFPB published the report marking two years into the pandemic, discussing concerns about medical debt collections and reporting that grew during the COVID-19 crisis. Let’s connect the dots on: A joint announcement this week from three major credit agencies,

Aflac, our favorite duck-mascot-representing company, has launched the Close the Gap initiative featuring spokesman Deion Sanders, one of the good guys in the Football Hall of Fame. Recognizing the fact that nearly one-half of insured Americans don’t have enough in savings to pay for medical expenses, the company established the Aflac Care Index to educate and advocate for peoples’ health and financial security — including those people who have health care coverage. While U.S. consumers are facing historically high levels of inflation for household spending on food, petrol, and home goods, health consumers will be dealing with greater out-of-pocket spending based

In the U.S., being covered by health insurance is one of the social determinants of health. Without a health plan, an uninsured person in America is far more likely to file for bankruptcy due to medical costs, and lack access to needed health care (and especially primary care). But even with health insurance coverage, most health-insured people are concerned about medical costs in America, found in a MITRE-Harris Poll on U.S. consumers’ health insurance perspectives published today. “Even those fortunate to have insurance struggle with bills that result from misunderstanding or underestimating costs of treatments and procedures,” Juliette Espinosa of

The coronavirus pandemic put health care at the top of peoples’ minds all over the world. As important as health became to humans at the base of our Hierachies of Needs, in the U.S., health care industries fell to their lowest consumer satisfaction scores in two decades, we learn in the latest evaluation by the American Consumer Satisfaction Index report. I explore consumer-patient experience for hospitals, health plans and ambulatory care compared with other industries in the November 2021 Medecision Liberation blog, calling out the importance of two key factors that drove peoples’ positive perceptions of brands and products in

“Americans remain in limbo between lives once lived and whatever the post-pandemic future holds,” the American Psychological Association observes in their latest read into Stress in America 2021, with this phase of the perennial study focused on Stress and Decision-Making During the Pandemic. The top-line: people face a daily web of risk assessment, up-ended routines, and endless news about the coronavirus locally and globally. While most people in the U.S. believe that “everything will work out” after the pandemic ends, the mental, emotional, and logistical daily distance between “now” and “then” brings uncertainty and indeed, prolonged stress. More Millennials, who

In the U.S., peoples’ expectations of their health care experience is melding with their best retail experience — and that’s taken a turn toward their digital and ecommerce life-flows. The American Customer Satisfaction Index Insurance and Health Care Study 2020-2021 published today, recognizing consumers’ value for the quality of health insurance companies’ mobile apps and reliability of those apps. Those digital health expectations surpass peoples’ benchmarks for accessing primary care doctors and specialty care doctors and hospitals, based on ACSI’s survey conducted among 12,274 customers via email. The study was fielded between October 2020 and September 2021. Year on year,

COVID-19 exacted a toll on health citizens’ mental health, worsening a public health challenge that was already acute before the pandemic. It’s World Mental Health Day, an event marked by global and local stakeholders across the mental health ecosystem. On the global front, the World Health Organization (WHO) describes the universal phenomenon and burden of mental health on the Earth’s people… Nearly 1 billion people have a mental disorder Depression is a leading cause of disability worldwide, impacting about 5% of the world’s population People with severe mental disorders like schizophrenia tend to die as much as 20 years earlier

Financial Experience (let’s call it FX) is the next big thing in the world of patient experience and health care. Patients, as health consumers, have taken on more of the financial risk for health care payments. The growth of high-deductible health plans as well as people paying more out-of-pocket exposes patients’ wallets in ways that implore the health care industry to serve up a better retail experience for patients. But that just isn’t happening. One of the challenges has been price transparency, which is the central premise of this weekend’s New York Times research-rich article by reporters Sarah Kliff and